AVAILABILITY OF AUTOLOGOUS TRANSFUSION IN BILATERAL SAGITTAL SPLIT RAMUS OSTEOTOMY FOR MANDIBULAR PROGNATHISM

하악전돌증 환자의 하악지 시상분할 골절단술에서 자가수혈의 유용성

  • Han, Sang-Jeong (Department of Oral and Maxillofacial Surgery, College of Medicine, The Inje University) ;
  • Zang, Ju-Min (Department of Oral and Maxillofacial Surgery, College of Medicine, The Inje University) ;
  • Oh, Han-Seok (Department of Oral and Maxillofacial Surgery, College of Medicine, The Inje University) ;
  • Lee, Hae-Kyung (Department of Orthodontics, College of Medicine, The Inje University) ;
  • Lee, Jeong-Nyeo (Department of Laboratory Medicine, College of Medicine, The Inje University) ;
  • Lee, Su-Woon (Department of Oral and Maxillofacial Surgery, College of Medicine, The Inje University) ;
  • Park, Sang-Jun (Department of Oral and Maxillofacial Surgery, College of Medicine, The Inje University) ;
  • Kim, Woo-Hyung (Department of Oral and Maxillofacial Surgery, College of Medicine, The Inje University)
  • 한상정 (인제대학교 의과대학 부산백병원 치과학교실 구강악안면외과) ;
  • 장주민 (인제대학교 의과대학 부산백병원 치과학교실 구강악안면외과) ;
  • 오한석 (인제대학교 의과대학 부산백병원 치과학교실 구강악안면외과) ;
  • 이해경 (인제대학교 의과대학 부산백병원 치과학교실 교정과) ;
  • 이정녀 (인제대학교 의과대학 부산백병원 치과학교실 진단검사의학과) ;
  • 이수운 (인제대학교 의과대학 부산백병원 치과학교실 구강악안면외과) ;
  • 박상준 (인제대학교 의과대학 부산백병원 치과학교실 구강악안면외과) ;
  • 김우형 (인제대학교 의과대학 부산백병원 치과학교실 구강악안면외과)
  • Published : 2007.10.31

Abstract

Objective: Autologous transfusion is frequently used with orthognathic surgery. The necessity of autologous transfusion has begun to question alone in bilateral sagittal split ramus osteotomy. The aim of this study was to evaluate the availability of autologous transfusion. Methods: The chart reviews of sixty patients who had undergone bilateral sagittal ramus osteotomy were done. The subjects were divided into two groups: In experimental group, 30 patients who autodonated 320ml in the preoperative 3 weeks actually received a transfusion in the postoperative 6 hours were included. In control group, 30 patients who underwent the same operation without preoperative donation and any other transfusion were included. Hemoglobin, hematocrit, and changes of these values in both groups were evaluated. Results: 1. From postoperative 3 hours to postoperative 1 day, the increases of hemoglobin(0.8g/dL in experimental group, 0.2g/dL in control group) and hematocrit(0.3% in experimental group, 0.6% in control group) were not statistically significant between both groups. 2. From postoperative 1 day to postoperative 1 week, the increase of hemoglobin(0.6g/dL in experimental group, 0.3g/dL in control group) was not statistically significant between both groups. But the increase of hematocrit(2.5% in experimental group, 1.0% in control group) was statistically significant between both groups over the same period(hematocrit p=0.043). 3. On postoperative 1 week, the values of hemoglobin(12.3% in both groups) and hematocrit(35.6% in experimental group, 36.8% in control group) were not statistically significant between both groups. Conclusion: The autologous transfusion in surgery of just a little blood loss was not effective. The most results show that there is little availability of autologous transfusion according to changes of hemoglobin and hematocrit in bilateral sagittal split ramus osteotomy.

Keywords

References

  1. 배준수, 류정호, 유준영, 김용관, 신동용, 이창선: 악교정 수술시 출혈량과 수혈에 관한 임상적 연구. 대한악안면성형재건외과학회지 1996;20:300-304
  2. Kruskall MS, Glazer EE, Leonard SS, Willson SC, Pacini DG, Donovan LM, et al: Utilization and effectiveness of a hospital autologous blood donor program. Transfusion 1986;26(4):335-40 https://doi.org/10.1046/j.1537-2995.1986.26486262740.x
  3. Lubin J, Greenberg JJ, Yahr WZ, Haynes JL, Paul E: The use of autologous blood in open-heart surgery. Transfusion 1974;14(6):602-7 https://doi.org/10.1111/j.1537-2995.1974.tb04587.x
  4. 한규섭, 권석운, 조한익: 수술전 혈액예치식 자가수혈의 경험. 대한수혈학회지 1990;1:65-71
  5. Neuwirth BR, White RP, Collins ML, Phillips C: Recovery following orthognathic surgery and autologous blood transfusion. Int J Adult Orthodon Orthognath Surg 1992;7(4):221-8
  6. Rolling RG, Zimmermann AP, Biro P, Haers PE, Sailer HF: Alternative methods for reduction of blood loss during elective orthognathic surgery. Int J Adult Orthodon Orthognath Surg 1999;14(1):77-82
  7. Husted H, Blond L, Sonne-Holm S, Holm G, Jacobsen TW, Gebuhr P: Tranexamic acid reduces blood loss and blood transfusions in primary total hip arthroplasty. Acta Orthop Scand 2003;74(6):665-9 https://doi.org/10.1080/00016470310018171
  8. Marciani RD, Dickson LG: Autologous transfusion in orthognathic surgery. J Oral Maxillofac Surg 1985;43(3):201-4 https://doi.org/10.1016/0278-2391(85)90160-0
  9. Puelacher W, Hinteregger G, Nussbaumer W, Braito I, Waldhart E: Preoperative autologous blood donation in orthognathic surgery, a follow-up study of 179 patients. J Craniomaxillofac Surg 1998;26(2):121-5 https://doi.org/10.1016/S1010-5182(98)80052-8
  10. Ueki K, Marukawa K, Shimada M, Nakgawa K, Yamamoto E: The assessment of blood loss in orthognathic surgery for prognathia. J Oral Maxillofac Surg 2005;63:350-4 https://doi.org/10.1016/j.joms.2004.05.226
  11. Nkenke E, Kessler P, Wiltfang J, Neukam FW, Weisbach V: Hemoglobin reduction and necessity of transfusion in bimaxillary orthognathic surgery. J Oral Maxillofa Surg 2005;63(5):623-8 https://doi.org/10.1016/j.joms.2005.01.005
  12. 장현호, 류성호, 강재현, 이승호, 김재승: 악교정 수술후 출혈양과 혈액학적 변화에 대한 임상연구. 대한구강악안면외과학회지 2001;27:435-41
  13. Goodnough LT, Brecher ME, Kanter MH, AuBuchon JP: Transfusion medicine. second of two parts - blood conservation. N Engl J Med 1999;340(7):525-33 https://doi.org/10.1056/NEJM199902183400706
  14. Habler O, Messmer K: Methods for reduction of homologous blood transfusions in operative medicine. Aneaesthesist 1997;46(11):915-26 https://doi.org/10.1007/s001010050487
  15. Christopoulou M, Derartinian H, Hatzidimitriou G, Iatrou L: Autolgous blood transfusion in oral and maxillofacial surgery patients with the use of erythropoietin. J Craniomaxillofac Surg 2001;29(2):118-25 https://doi.org/10.1054/jcms.2001.0200
  16. Kowalyshyn TJ, Pragner D, Young J: A review of the present status of preoperative hemoglobin requirements. Anesth Analg 1972;51(1):75-9
  17. Kosanin R, Riefkohl R: Transfusing plastic surgical patients. Plast Reconstr Surg 1985;75(1):131-2 https://doi.org/10.1097/00006534-198501000-00034
  18. Hillman KM: Crystalloid or colloid? : Br J Hosp Med 1986;35(4):217
  19. Schaberg SJ, Kelly JF, Terry BC, Posner MA, Anderson EF: Blood loss and hypotensive anesthesia in oral-facial corrective surgery. J Oral Surg 1976;34(2):147-56
  20. Tremper KK: Techniques and solutions to avoid homologous blood transfusion. ASA Annual Refresher Course Lectures. American Society of Anesthesiologists 1993;214:1-7
  21. Nath A, Pogrel MA: Preoperative Autologous blood donation for oral and maxillofacial surgery. J Oral Maxillofac Surg 2005;63(3):347-9 https://doi.org/10.1016/j.joms.2004.05.225